Senior Business Systems Analyst - Remote

UnitedHealth Group•Plymouth, MN

2d•$91,700 - $163,700•Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. We are recruiting for a Senior Business Systems Analyst – Remote to join our Optum Application Managed Services (AMS) team. The AMS team engages in short- and long-term commitments and partnerships and provides full service operational support to our clients with a proactive approach to business communication, efficiency, and problem resolution. The AMS team partners with health plan clients to become an extension of their organization. The highly seasoned staff is dedicated to managing Prospective Payment Systems (PPS) as well as looking at where PPS fits in the clients “Ecosystem.” AMS provides services that will help provide long term benefit for the client, not only direct resource savings, but also savings in process, manual effort and other operational areas. The Senior Business Systems Analyst is responsible for ensuring effective delivery of ongoing maintenance, supporting integration, configuration, and migration efforts. Business Systems Analysts are measured on service quality, systems knowledge development, and relationship building within assigned client portfolio. Additionally, the Business Systems Analyst may be responsible for project planning, client reporting, NPS improvement, and client by client SLA tracking. The Senior Business Systems Analyst must also have the ability to facilitate internal or external meetings and drive effective solutions. The successful Business Systems Analyst candidate will have solid communications skills and the ability to liaison between technical and claims operations personnel. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Requirements

5+ years of experience working in a healthcare data or regulatory environment
3+ years of experience with installing, troubleshooting, and using Optum's EASYGroup, Web Services, WebStrat, Optum Payment System Interface, and/or Rate Manager
3+ years of experience in pricing Medicare hospital facility claims (inpatient and outpatient)
Claims system experience - Homegrown claims system (specify), Trizetto Facets, NetworXks Pricer, QNXT, Health Rules Payer, IKA Claims, Burgess Systems, Epic Tapestry, 3M preferred
Experience breaking down information and developing solutions
Health plan experience in facility contract configuration, claims or IT
Experience documenting client operational and technical workflow
Experience configuring and customizing software solutions
SQL experience writing queries, navigating DBs, and researching data
Experience with installing, troubleshooting, and navigating RESTful Web Services
Experience with healthcare claims data, PPS concepts, UB04 and HCFA 1500 claim content
Proven experience with using .NET and IIS
Basic knowledge and understanding of Prospective Payment Systems - includes DRG, APC, OCE, ESRD, CAH, CMG, RUG, RBRV
Facility claims reimbursement knowledge - Medicare, Medicaid, Commercial
Intermediate knowledge and usage of with Microsoft Word, Excel, PowerPoint, Visio

Nice To Haves

Some SQL experience
Python experience
Experience in API's
Experience in Postman

Responsibilities

Ensures successful installation, implementation, configuration and integration
Work with Optum customers and vendor partners on configuration, use, and troubleshooting of Optum Web Service and Payment System Interface Cloud solutions
Apply analytical / quantitative approach to problem solving
Experience on obtaining and using PPS data for troubleshoot and analysis
Comfortable and actual experience with statistical concepts to assist with PPS claims analysis
Utilize communication skills to influence and negotiate
Utilize one’s solid interpersonal skills to work with all levels of management across all functional areas, as well as, business partners through internal entities
Work within client ticketing system to track escalated issues, input new issues or answer issues sent in by other teams. Communicate any responses back to client and ensure understanding of the content
Implement changes as needed and outlined in contract
Work directly with Optum colleagues and customers to document and deliver Client PPS payment system methodology education needs
Work directly with Optum colleagues and clients to document and deliver Client requirements for Optum PPS product training
Works directly with customers to define other project requirements, provide assistance to answer questions related to project results
Assist as needed with other Reimbursement Solutions projects
Engage with dedicated clients either VPN or Remote, WebEx to apply updates or Troubleshoot issues using documentation from Regulatory
Supports Optum Business Partners with technical implementation and integration questions. Offers recommendations for interface improvements from a technical perspective
Compile Documentation: Processes and Procedures (including but not limited to Clients specific tracking, network configuration, rules of engagement)